Coming off Methotrexate

Wall_Watcher

Hi All! First post 😊 Was directed to this community by a lovely lady on the Versus helpline. Sorry, really bad with names. think it was Sarah.

Bit about me. Have lived with Psoriasis from age 10, been on various treatments over the years and currently using Dovobet which works well for me. I was diagnosed with Psoriatic Arthritis around 18 months ago and have been on Methotrexate for around 14 months, it worked well reducing inflammation/pain but always gave me nausea on day 1 and 2 of taking. I recently started getting really bad side affects so have had to stop.

My consultant has offered 2 alternatives to try. Leflunomide and Sulphasalazine. Doing a bit of research it seems that Sulphasalazine is less "aggressive" with milder side effects? I understand everyone is different and can react differently so its difficult to decide which way to go...... I may even stay drug free for a bit and see how i go. I just don't want the condition to get worse.

Can anyone share their own experience from being in a similar situation? Any help is appreciated 😀

Anna

Hi @Wall_Watcher and welcome to the online community,

It's great to hear of your positive experience with our Helpline - I'll pass on your comments as I'm sure they will be appreciated! I'm sure you'll find the same friendly experience from our members too!

So you were diagnosed with psoriatic arthritis 18 months ago and are now considering a new treatment after experiencing bad side effects on methotrexate. It's not unusual to have to try out a few new treatments because what suits one doesn't always suit another, so it can take a while to settle down.

You've been asked to consider two alternatives. It sounds like you've been doing your own research, and Helplines have probably given you some information, but just in case you've missed this, here's the link to the Versus Arthritis page on psoriatic arthritis where you can find out more about the various treatments:

https://www.versusarthritis.org/about-arthritis/conditions/psoriatic-arthritis/

I hope other members of the forum who have experience of taking either of the medications will come along soon to share their experiences.

Do have a look round the forum and join in wherever you feel comfortbale.

Anna (Mod)

stickywicket

Personally I've found methotrexate works very well for me. I've never done sulf but it seems (from reading on here) that it's used a lot for PsA. (Mine's RA)

I'd just caution against going meds-free, though. It's tempting, but we have overactive immune systems which need damping down. It can be very hard to recover lost ground if we give them their head.

jamieA

https://community.versusarthritis.org/discussion/58764/coming-off-methotrexate

Hi @Wall_Watcher

I've had psoriasis since I was about 15. In October 2020 at the age of 65 I was diagnosed with PsA. I was initially put on a build up to 3gms of sulfasalazine a day. It didn't make a difference for me and my symptoms were worsening so 3 months later MTX was added on a build up to 20mgs. That didn't work either so I was eventually put on the biologic adalimumab 9 months after first diagnosis - this was added to the sulfasalazine and MTX. I was given the impression that that was the normal path of medication progression.